Our Director of Research reports back from the world’s largest dementia research conference
I joined Alzheimer’s Research UK in September 2020, in the midst of COVID restrictions, a burgeoning remote working culture, and a growing trend for virtual meetings and events.
Last year I remotely joined the largest annual meeting of dementia researchers, the Alzheimer’s Association International Conference (AAIC), by way of their impressive virtual platform. I was able to watch videos of research presentations, post questions and comments to other attendees, and read posters describing recent experiments. It was very well put together and a valuable experience for me, but despite the best efforts of the organisers, something important was missing.
A big part of a research conference is the in-person interaction with other attendees – scientists can debate new findings after a talk, challenge a colleague’s inferences and test their own ideas in conversation with others. These more informal elements of a conference are typically what spark new ideas, and in person networking is vital for forming new collaborations that will drive progress towards life changing breakthroughs.
So earlier this month I was very excited to physically attend AAIC 2022. I was particularly proud to see ARUK-funded scientists, and advisors sharing their findings with the global dementia research community and taking part in the research discussions that are such an important part of science.
Prof James Rowe is the Chair of Alzheimer’s Research UK’s Scientific Advisory Board and is currently leading efforts to ensure our research strategy has the greatest possible impact for people with dementia.
Prof Rowe is a neurologist and a world leading researcher with particular expertise in frontotemporal dementia – a condition that mostly affects people between 45 and 65 years of age. His presentation showed how MRI scans are building our understanding of how FTD develops and affects the brain, their potential for supporting accurate and timely diagnosis, and how they can improve clinical trials of potential drugs for people with the disease.
Plenary sessions are for the entire conference to come together and hear about research that affects the dementia research field as a whole.
On the second day, Dr Thomas Beach, from the Banner Sun Health Research Institute in the US, gave a plenary talk focussed on neuropathology – the physical changes in the brain caused by diseases like Alzheimer’s. Neuropathology really kicked off Alzheimer’s research when Dr Alois Alzheimer first identified the build-up of amyloid and tau protein that defines the disease. The field of neuropathology has come a long way since then.
Dr Beach used this opportunity to outline a big challenge that dementia researchers will need to tackle as we move towards new treatments. He presented findings from brain tissue samples donated by people who died with a form of dementia. He showed that most people who are diagnosed with Alzheimer’s also had other disease processes underway in their brains. While people may sometimes be diagnosed with mixed dementia (usually Alzheimer’s and vascular dementia) at the moment this is very much the exception rather than the rule.
What do multiple diseases mean for people with dementia? When it comes to causing damage to cells in the brain, which processes are drivers, and which are the passengers?
Does it mean that if we can treat the Alzheimer’s changes, will the other changes go away? Will it mean that our current diagnosis categories are not good enough and that, to make real progress we will have to be more specific about specific combinations of disease processes and be more tailored to an individual’s needs?
Understanding diseases is crucial for effective treatments. This is a major challenge for research and one that we will need to grapple with if we are to treat people effectively. Fortunately, Dr Beach also had ideas about how we can do this. He is optimistic about research into ways to tackle disease processes that are shared by different forms of dementia – some of which are already being pursued by initiatives like Alzheimer’s Research UK’s Drug Discovery Alliance.
Blood tests – first steps into the clinic.
Over the last decade, blood tests for Alzheimer’s disease have been inching closer to use by doctors in the clinic. These tests measure levels of proteins in the blood that reflect Alzheimer’s changes underway in the brain.
Multiple conference sessions were dedicated to this exciting and important area of research. Researchers highlighted how blood tests could support more effective clinical trials, compared different blood tests for accuracy in different groups, and presented findings from experiments where blood tests were used in combination.
Prof Charlotte Teunissen from Amsterdam University Medical Centres has led work looking at how we can start to use blood tests to support diagnosis. Her expert group now recommend cautiously starting to use blood tests in specialist clinics to help determine the cause of a person’s symptoms in conjunction with memory and thinking tests and brain scans.
This is a critical first step, but we are still a long way from the point where anyone could go to their GP and take a blood test to see if a disease like Alzheimer’s has started to get underway in the brain.
We are now entering a new era of blood tests. While this could potentially revolutionise diagnosis, this will happen very gradually. Alzheimer’s Research UK is planning new initiatives in this area of research so that we can rapidly unlock the potential of blood tests and make sure they start benefiting people as soon as possible.
Early Detection of Neurodegenerative diseases (EDoN) is an ambitious project spearheaded by Alzheimer’s Research UK to develop an innovative approach to detect diseases like Alzheimer’s years before the symptoms of dementia start.
At the conference Dr Dennis Chan presented an overview of the EDoN initiative as part of a session on technology that can detect the very earliest stages of cognitive change.
He was able to update fellow researchers about the progress of the initiative and answer questions about the early stages of this major international research collaboration. Digital technology holds so much potential for how we detect the earliest symptoms of neurodegenerative diseases, and it was really great to see this topic getting the attention it needs.
The conference was also a chance to hear about the latest results from dementia clinical trials. Researchers are taking many different approaches to developing effective treatments and it is crucial that the field maintains a healthy pipeline of potential treatments that focus on different aspects of disease biology.
A frequent topic of conversation between delegates was what to make of the controversial drug aducanumab, which was approved by US drug regulators under the strict condition that the company continues to collect data about real world clinical effectiveness. European regulators did not approve drug.
It is a crucial time in dementia research as new developments from research start to make their way into the clinic. There are currently 143 potential Alzheimer’s treatments in clinical trials, including 31 in phase III and many more in development. The feeling from the conference was one of optimism and determination. It was fantastic to get together with researchers from all around the world who are taking on our greatest medical challenge. Alzheimer’s Research UK is playing a key role in international efforts to end the fear, harm and heartbreak of dementia and it is thanks to our supporters who make breakthroughs possible.
Donate today to support vital dementia research.